Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan.
Ann Neurol. 2015 Jan;77(1):58-67. doi: 10.1002/ana.24299. Epub 2014 Nov 13.
Fast oscillations (FOs) were first explored from scalp electroencephalographic (EEG) data from hypsarrhythmia in West syndrome (infantile spasms) to investigate the meaning of FOs in this epileptic encephalopathy.
In 17 infants with West syndrome, we conservatively detected fast frequency peaks that stood out from the time-frequency spectral background with square root power > 1µV (spectral criterion) and corresponded to clear FOs with at least 4 oscillations in the filtered EEG traces (waveform criterion) in sleep EEGs.
We found a total of 1,519 interictal FOs that fulfilled both the spectral and waveform criteria. The FOs with a median frequency of 56.6Hz (range = 41.0-140.6Hz) were dense, with a median rate of 66 (range = 24-171) per minute before adrenocorticotropic hormone (ACTH) treatment, which was significantly higher than that in control infants without seizures (median = 1, p < 0.001). The FOs were reduced by treatment. The mean gamma and ripple oscillation rates that were detected using the waveform criterion alone were 40.62/min and 15.75/min, respectively, per channel; these results were 112.8 and 98.4 times higher, respectively, than the previously reported corresponding rates in adult epilepsy patients.
The observed FOs corresponded to epileptogenicity because of their close relation to the severity of hypsarrhythmia during the course of ACTH treatment. The very high epileptic FO rates in hypsarrhythmia are thought to affect the process of neurodevelopment by interfering with physiological functions in West syndrome, taking into account that high frequencies are also important in physiological higher brain functions.
首次从婴儿痉挛症（West 综合征，一种婴儿期癫痫性脑病）的高幅失律脑电图中探索快振荡（FOs），以研究 FOs 在这种癫痫性脑病中的意义。
在 17 例 West 综合征婴儿中，我们采用保守方法检测快频峰，这些快频峰从时频谱背景中突出出来，平方根功率>1µV（谱标准），并且与滤波脑电图轨迹中的清晰 FOs 相对应，至少有 4 个振荡（波形标准）在睡眠脑电图中。
我们共发现 1519 个满足谱和波形标准的发作间期 FOs。FOs 的中位数频率为 56.6Hz（范围=41.0-140.6Hz），密度较高，在促肾上腺皮质激素（ACTH）治疗前的中位数率为 66（范围=24-171）/分钟，明显高于无癫痫发作的对照婴儿（中位数=1，p<0.001）。FOs 在治疗后减少。仅使用波形标准检测到的平均γ和涟漪振荡率分别为 40.62/min 和 15.75/min/通道；这些结果分别比之前报道的成人癫痫患者的相应比率高 112.8 倍和 98.4 倍。
观察到的 FOs 与致痫性密切相关，因为它们与 ACTH 治疗过程中高幅失律的严重程度密切相关。高幅失律中非常高的癫痫 FO 率被认为通过干扰 West 综合征中的生理功能来影响神经发育过程，考虑到高频在生理更高脑功能中也很重要。
